UPDATED_Attachment_G1_Past_Performance_11.27.17.docx

Attachment G- R17PS00246 IT Risk Management Services IDIQ

PAST/PRESENT PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104

SECTION 1: CONTRACT IDENTIFICATION

1. Contractor:

1. Cage Code of contractor contract was awarded to:

1. Role (check): Prime Subcontractor Teaming Partner Joint Venture Partner Other (specify)

If subcontractor, partner or other, who is the Prime?

1. Contract Number:

1. Contract Vehicle: (IDIQ Contract, IDIQ Task Order)

1. Contract Type: (CPFF, CPIF, CPAF, FFP, T&M, Other)

1. Contract Clearance Requirement (e.g. Unclassified, NAC, Secret, Top Secret):

1. Was this a competitive contract? Yes _____ No _____

1. Period of performance:

1. Initial contract cost: $

1. Current/final contract cost: $

1. Reasons for differences between initial contract cost and final contract costs:

1. Description of service provided:

SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION

1. Customer or agency name:

1. Customer or agency description (if applicable):

1. Geographic description of services under this contract, i.e. local, nationwide, worldwide, other Commands:

SECTION 3: EVALUATOR IDENTIFICATION

1. Evaluator's name:

1. Evaluator's title:

1. Evaluator's phone and email:

1. Number of years evaluator worked on subject contract:

SECTION 4: EVALUATION

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question for Management Approach with 5 questions. This scale is defined as follows:

CODE PERFORMANCE LEVEL

MA-1. Ability to manage a large contract and a large team

MA-2. Ability to plan, control, monitor, and report cost, schedule and performance metrics.

MA-3. Ability to recruit, staff, retain, train, and replace qualified employees with appropriate security clearances (e.g. Secret, Top Secret, etc.).

MA-4. Ability to meet your requirements and deadlines?

MA-5. Ability to understand the nature of the work required and the skills required to accomplish it?

Please provide a summary of the Management ratings you provided including particular attention to the definitions provided above for E (Exceptional), M (Marginal) or U (Unsatisfactory) in response to the questions above (use additional sheets, if necessary).

3. Government Contracts Only: Has/was this contract been partially or completely terminated for convenience or default or are there any pending terminations?

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).

SECTION 5: NARRATIVE SUMMARY

Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs?

Do you know of another source that has knowledge of this contractor’s performance?

Name / Company:

Phone Number:

Please provide any additional comments concerning this contractor’s performance, as desired.

Evaluator’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire via email to:

Christina Mohamed Cmohamed@usbr.gov